The research extends a previous study on the recognition, response and long-term adaptation to severe mental illness by families of mental patients, as reconstructed through a series of interviews with the patient's spouse beginning soon after initial hopitalizationand carrying through the period of hospitalization. Data were collected from more than 50 families in Washington, D.C. and Maryland suburbs in 1952-60. These families are being followed up as are members of a smaller chohort studied in the San Francisco Bay Area in 1958-59. In addition, new cohorts of patients and families will be studied in each of the areas that were focal points in the previous research. The new samples of patients will be selected to be comparable in demographic characteristics and symptomatology to the original samples, but half of the new cohorts will represent patients experiencing hospitalization and half patients experiencing out-patient treatment (if such can be located). The time span covered by the research should permit inferences both as to the long-term consequences of mental illness for the family and a to the ways that changes in community mental health facilities have influenced the meaning and consequences of the patients's illness for his family.